MEDICARE: ALLYSSA YOUNG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1841712734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLYSSA YOUNG

Provider Business Mailing Address
First Line	:	5800 W 10TH ST STE 600
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72204-1761
Country	:	US
Telephone Number	:	501-666-6868
Fax Number	:

Provider Business Practice Location Address
First Line	:	5800 W 10TH ST STE 600
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72204-1761
Country	:	US
Telephone Number	:	501-666-6868
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2017
Last Update Date	:	07/21/2022

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Directions to “ ALLYSSA YOUNG ” Practice Location

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